Comparison of the effects of local and systemic dexamethasone on the rat traumatic sciatic nerve model.

AIM: The aim of the study was to evaluate the effect of peroperatively locally administered dexamethasone on nerve recovery after induced nerve crush injury. MATERIAL AND METHODS: 4 groups of 8 animals were formed. The sciatic nerves of 32 rats were exposed at midthigh level and those of 24 rats were crushed for 30 seconds with a pair of jeweler's forceps. RESULTS: Sciatic functional index (SFI) measurements of all the animals included at days 7, 14, 21 and 28 was statistically significant (p < 0.05). Pinch tests that were done on the first 13 days gave negative results in all the groups. There was a difference between the test results of Group II and those of Group III and IV at days 14, 21 and 28. When the duration of the experiment was taken as a whole, no difference was observed between the test results of Group III and IV. CONCLUSION: Recovery in the group treated with local dexamethasone was more remarkable than that in the group treated with systemic dexamethasone in our study. As the difference was statistically significant, we recommend the perioperative use of local dexamethasone in procedures that might induce nerve injury.

A practical laboratory study simulating the percutaneous lumbar transforaminal epidural injection: training model in fresh cadaveric sheep spine.

AIM: Laboratory training models are essential for developing and refining treatment skills before the clinical application of surgical and invasive procedures. A simple simulation model is needed for young trainees to learn how to handle instruments, and to perform safe lumbar transforaminal epidural injections. Our aim is to present a model of a fresh cadaveric sheep lumbar spine that simulates the lumbar transforaminal epidural injection. MATERIAL AND METHODS: The material consists of a 2-year-old fresh cadaveric sheep spine. A 4-step approach was designed for lumbar transforaminal epidural injection under C-arm scopy. RESULTS: For the lumbar transforaminal epidural injection, the fluoroscope was adjusted to get a proper oblique view while the material was stabilized in a prone position. The procedure then begin, using the C-arm guidance scopy. CONCLUSION: The model simulates well the steps of standard lumbar transforaminal epidural injections in the human spine. The cadaveric sheep spine represents a good method for training and it simulates fluoroscopic lumbar transforaminal epidural steroid injection procedures performed in the human spine.

[Venous port implantation in adult patients: retrospective evaluation]. / Eriskin hastalarda venöz port implantasyonu: Retrospektif degerlendirme.

OBJECTIVES: In the cancer therapy, the role of central venous access device has been increased because of factors; such as accessing to vein frequently, having long term therapy, using of sclerosan agents, giving much fluid. A chemoport is a thin, soft, plastic tube surgically implanted into a vein in chest or arm. Portacath doesn't have a huge size and it can generate numerous advantages. All the same, portacaths have risks such as infection, thrombosis, mechanical failure, pneumothorax, arterial injury. METHODS: A retrospective study was performed with analysis of records of 82 patients admitted to our clinics between December 2006 and November 2008 for permanent catheterisation via subclavian vein. RESULTS: The most frequent complication was occlusion of port (3.66%). Further complications were infection (2.43%), migration out of the blood vessel (1.22%), and catheter rupture (1.22%). CONCLUSION: As a result, made by people who experienced venous ports inserted, provided the opinion that a safe and comfortable method.

One-stage surgery through posterior approach-for L5-S1 spondyloptosis.

Grade 5 spondylolisthesis or spondyloptosis is a rare condition. Generally, the surgical management of spondyloptosis includes multi-staged procedures instead of one-staged procedures. One-stage treatment for spondyloptosis is very rare. A 15-year-old girl with L5-S1 spondyloptosis was admitted with severe low back pain. There was no history of trauma. The patient underwent L5 laminectomy, L5-S1 discectomy, resection of sacral dome, reduction, L3-L4-L5-S1 pedicular screw fixation, and interbody-posterolateral fusion through the posterior approach. The reduction was maintained with bilateral L5-S1 discectomy, resection of the sacral dome, and transpedicular instrumentation from L3 to S1. In this particular case, one-staged approach was adequate for the treatment of L5-S1 spondyloptosis. One-staged surgery using the posterior approach may be adequate for the treatment of L5-S1 spondyloptosis while avoiding the risks inherent in anterior approaches.